title: Synchronous colorectal neoplasms in ulcerative pancolitis of 6 years duration: pathological and molecular heterogeneity.
abstract: Colorectal cancer (CRC) complicating ulcerative colitis (UC) accounts for about 1% of all cases of CRC. Such tumours develop from pre-existing foci of dysplasia in patients with extensive and long-standing UC. We report a case of UC-associated synchronous CRC and foci of high-grade dysplasia with an additional malignant focus in the appendix in a female patient after only 6 years of pancolitis who did not have other risk factors for the development of complications. The multiplicity and the timings of the early changes noted suggest that long-standing inflammation in UC randomly damages multiple genes in epithelial cells known to contribute to colorectal carcinogenesis. Current findings also support a molecular and pathological heterogeneity during multiclonal origin of synchronous tumours whereby differences occur at various sites that were absent during the initial stages of the disease.
authors.affiliation: Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: B M
authors.initials: BM
authors.lastname: Shivakumar
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Rao
authors.forename: K
authors.initials: K
authors.lastname: Satyamoorthy
authors.forename: Ganesh C
authors.initials: GC
authors.lastname: Pai
mesh_terms: D000293:Adolescent; D003093:Colitis, Ulcerative / Q000150:complications / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000150:complications / Q000235:genetics* / Q000473:pathology*; D005260:Female; D018740:Genetic Heterogeneity; D006801:Humans; D007150:Immunohistochemistry